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From Global Trends To Patient-Level Data: Helping Adolescents With Sickle Cell Disease Become Adults
No full textSickle cell disease (SCD) is an inherited hemoglobinopathy that remains a major contributor to global morbidity and mortality. While advances in neonatal screening, therapeutic interventions, and supportive care have significantly improved survival rates, individuals with SCD continue to experience challenges, particularly during pediatric to adult healthcare. Health care transition (HCT) represents a critical period associated with increased healthcare utilizations and a heightened risk of mortality. Although structured transition programs have been implemented in high-income countries (HICs), transition readiness remains largely unaddressed in low- and middle-income countries (LMICs), including Brazil. The dissertation aims to assess the burden of SCD, identify the key determinants influencing HCT in Brazil, and evaluate predictors to transition readiness in both Brazil and the United States. The overarching objective is to understand the cultural context of transition readiness in an LMIC setting to inform scalable interventions. In the first aim examined the contemporary burden of SCD among individuals under-5 and under-20, revealing an overall prevalence of 0.9%, with 0.9% among children under-5 and a proportion of 1.8% among those under-20. The second aim identified key determinants for HCT, including structural and systematic challenges, the emotional impact of transition, and the need for improved patient-provider communication. The third aim assessed transition readiness in two Brazilian institutions, with a comparative analysis to the United States. Results indicated that Brazilian patients and US share some of the same predictors to transition readiness (e.g. age) although Brazilian patients score, on average, 4.58 points lower than their US counterparts highlighting the potential benefits of implementing a formalized transition program. As individuals with SCD reach adulthood, the establishment of a structured program is essential to ensuring continuity of care and improve health outcomes. However, transition models effective in HICs may not be directly transferable to LMIs, emphasizing the need for context-specific adaptations. Understanding the cultural and systemic factors influencing transition readiness is critical to developing sustainable and effective HCT programs in resource-limited settings
Equity in School Counseling: School Administrations\u27 Perception of School Counselor Roles for Supporting the Academic and Social-Emotional Development of Black Students
Get PDFThis qualitative study explores the roles and responsibilities of school counselors, focusing on their collaboration with administrators in supporting Black students. The research aims to clarify administrator perceptions of counselors, examine systemic barriers to their collaboration, and assess institutional policies that influence equity-driven counseling practices. The study addresses three key research questions: (1) How do school counselors interpret their experiences related to power dynamics with administrators while advocating for Black students? (2) How do school administrators understand their roles and the roles of school counselors in fostering student support structures? and (3) How do school counselors and administrators perceive institutional policies affecting Black student advocacy. Using a qualitative design, semi-structured interviews were conducted with five school administrators and five school counselors. Thematic analysis revealed four major themes: (1) the importance of collaborative relationships and power structures in student advocacy, (2) role ambiguity and administrative expectations limiting counselors\u27 effectiveness, (3) institutional policies affecting equitable resource allocation and disciplinary practices, and (4) the necessity for trauma-informed professional development for educators. The findings highlight the K.I.P.E.R.S. framework as a valuable tool for analyzing the intersection of knowledge, integration, power, equity, relationships, and support in school counseling. The study calls for policy reforms that allow counselors to engage in student advocacy without bureaucratic constraints
The Impacts of Model Selection on Effect Size Estimation and Precision in Longitudinal Ocular Research: A Simulation Study
Get PDFThis study evaluates common approaches to analyzing ocular longitudinal data. These approaches range from univariate multiple linear regression to mixed-effect modeling to bivariate outcome models, and vary in both overall complexity, and the amount of data used for analysis. Through comparisons of relative model precision and accuracy, the study highlights how modeling choices may affect inference in the context of ocular data analysis. Through the use of simulated datasets based on reference data from a previous longitudinal study of myopia, a total of ten modeling approaches are assessed. The data are simulated under four different correlation and effect size scenarios to examine the robustness of modeling approaches and to provide more generalizable results. These simulations consistently show that more complex mixed modeling approaches result in increased model precision, relative to models with only fixed effects. The benefits of three-level mixed models compared to two-level mixed models depend on if the predictor of interest is measured at the level of the subject or the eye. As correlation between outcomes is decreased, either between the left and right eye, or within an eye over time, mixed modeling approaches show further gains in precision. Notably, bivariate outcome modeling does not outperform univariate outcome mixed models in most scenarios. However, if effect sizes are not consistent between the left and right eye, bivariate outcome modeling is able to more accurately detect and estimate these different effect sizes compared to all other evaluated modeling approaches. These results may allow for more efficient analysis of ocular data, and may enable investigators to use fewer resources to reach the same conclusions
Advanced Search Strategies
No full textJessica McClure, Virtual Instruction Librarian & Assistant Professor, demonstrates graduate-level keyword searching and mining, Boolean logic, cross-referencing academic databases, and more
Envelope, to D.G. Hopkins
No full textEnvelope addressed to David G. Hopkins while in Ripon, Wisconsin from a sender in Sharon.https://digitalcommons.memphis.edu/speccoll-mss-hopkins1/1007/thumbnail.jp
Correspondence, N. Dunham to S. Hopkins 1877 October 7
No full textCorrespondence from Nancy Dunham to Sara Hopkins, 1877 October 7.https://digitalcommons.memphis.edu/speccoll-mss-hopkins1/1010/thumbnail.jp
Sexual Orientation, Rank, and Status
No full textDignity retains its ancient focus on rank and status. This Article, therefore, rejects the idea that we now live in the age of equal dignity, meaning equal rank and status for everyone. Rank underscores numbering, placement, and position in a predetermined hierarchy, and status underscores the power and privileges associated with each rank. Rank permits human beings to identify their preassigned location in the hierarchy, and status justifies assertions of rank since status governs the ancestral privileges, powers, and responsibilities attached to each rank. The Article relies on two constitutional cases, one before “dignity” and the other after. In 1986, the Supreme Court of the United States held in Bowers v. Hardwick that the Federal Constitution did not recognize a right to privacy preventing a state from criminalizin
Two Rules of Completeness
No full textThe evidentiary rule of completeness is a common law and statutory rule of fairness that prevents one party from creating a distorted picture out of partial evidence at trial.1 If a prosecutor admits one part of a defendant’s confession, “The murder weapon was mine,” the rule of completeness permits the admission of the second, “but I had sold it months earlier.”2 The version of the rule of completeness codified in Federal Rule of Evidence (“FRE”) 106 states: If a party introduces all or part of a statement, an adverse party may require the introduction, at that time, of any other part—or any other statement—that in fairness ought to be considered at the same time. The adverse party may do so over a hearsay objection.3 Thus, the rule of completeness is a powerful rule of inclusion that, while still subject to some rules of exclusion, can trump a hearsay objection
Central Police Station
No full texthttps://digitalcommons.memphis.edu/picturing-memphis-images/1219/thumbnail.jp